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General NPI Number Information
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NPI Number | 1235937863
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Entity Type | Organization
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Legal Business Name | WICHITA MIND & WELLNESS LLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 1210 N LAWRENCE LN
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City | WICHITA
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State | KS
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Zip | 67206-1451
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Country | US
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Telephone | 316-747-1578
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Fax |
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Provider Business Mailing Address
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Address Line | 4601 E DOUGLAS AVE STE 362
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City | WICHITA
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State | KS
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Zip | 67218-1011
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Country | US
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Telephone | 316-747-1578
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. HELENE J JURGENS
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Credential | PHD
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Telephone | 316-747-1578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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